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APPLICATI�►.d FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STAEET•EVERETT, WA 98201 •259•8810 <br /> rl DEMOLITION �1 COMBINATION n BUILOING �l MECHANICAL r� p�,UM81NG f l SIGN <br /> PROJECT ADDRESS <br /> L� �3 c �L� � <br /> '/��� ,�� MAIL�pDqE'_'S cin <br /> i1 . r�� ��,� �z � ) �c..c� q�z�� 2 c� ��� Y <br /> TFNRNT M41LAOpHE55 CITY 7�� PNONE <br /> S�i�C'�'x� �� i..(� /C,7 ,�i, - l- A.G. fi-�aHl� r/-�112 ?�6 - 3�� &�dZJ <br /> ARCMR[�t OR DESIG'1CF NRIL ADDqE55 CITV 71P PIION[ <br /> �CL- <br /> GENCqAtf_NiM�Tqi MAI�AppqE55 CITY Z�P PHONE GiRTELICENSE� <br /> MECHANICAL CO4TRaCiOR MM�AD�RE55 CITY jIP p110NF STATE LICENSE� <br /> � �I 5 �L r.+ vv�� <br /> PL INGCONiR f,jpq M4ILADDRES$ QN zIP p11UNE $TAiE1.ILENSE� <br /> C NTRRCiPRIG OfWqiK <br /> NEATING SYSTEM: f1GAS fIELECTRIC f� <br /> DESCRIBEWORKS 5pp�qEFOOT�GEINVOLVED� n�� � CO� Q FR'ONAN !'HONFNO 2 <br /> �ZO� <br /> L� 1 ! - , � <br /> Q i HERE6Y CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> vnorro vse ov euaon+c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7 q�� <br /> PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TVPE OF <br /> IEWLDESGRIPTIpNpFpqOPERTY(SI/OWN9ELOWONRTfRCHTWOLOi'IE51 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � tor BLOCK or_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STA7E OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV TkiE <br /> OWN'R OF THIS PROPERTY TO PERFORM THE WORK FOR WI�ICH <br /> APPLICATION IS MADE AND I COMPLY WITH TH[ STATE <br /> PARCELTIVX I.D.NVMBER CONTRACTOR5 LAW 18.27 RCW AND 296200 WAC. <br /> � <br /> GONSTRVCTIONLO�NIENOER,AUDHESS.TEIEPHONE NUMOFR X r�.,� 7���� <br /> %7 <br /> SIGN�TUR� f� DRTf. <br /> CI1Y pU51NE551 Ir�NS[NO <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FlKTURE OR ITEM FEE NO. TVPE OF EOUIPMENT PEE <br /> WATEFCLOSET�TOILET) � A/C—A/HNDLGUNITS—H.P. —r— <br /> BATHTUB � FORCED AIR SYSTEMS--B.T.U. M E.A. ' <br /> LAVATORV(WASH EASIN) � HEAT PUMP , <br /> SHOWER UNITHEATERS—O.T.U. M � <br /> KITCHEN SINK d DISP CIOTHES DRVERS � <br /> DISHWASHER � :�E-NTILATION FAN i <br /> IAUNGRY TRAY � RANGE HOOD � <br /> CLOTHES WASHER WATER HEATER � <br /> UR�NAI � WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR ORAIN fIREPLACE INSERT(WOOD BURNING) � <br /> AACKFLOW PREVENTERS � GASFIREPLACE ' <br /> SINK(SERVICE—DAR,ETC.) GAS RANGE � <br /> GAS PIPING <br /> i EXHAUSTFAN � <br /> i � <br /> � <br /> —T <br /> SUB TOTAL S � SUB TOTAL $ ' <br /> � <br /> PC9MIT $ � PERMIT $ i '— <br /> TOTALFEE $ � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> fRONT SFTPRCK qEqp SETBRCN SIDE SETBRLR PI�N CIIFfN N IUfIT fff PFf,FlM NO <br /> /lo ��,50 <br /> usezOnF iotnqen vncntiisire FEES VAWATION FEE <br /> i rvF; n rvo , n <br /> — ��,����,��; 71�P'J D ;o <br /> HEIGIIi LIMIiR710N NO OF DW[LUNG SIiE Of ALR.91 <br /> VNi75 j ��I)IAPINQ � <br /> I� .�• � <br /> OCWP�N�Y Npp�S�OFi15 OCLUP4NIlOAU BASFMENi I <br /> FROUP MF4M�MCAL � <br /> i <br /> IIY[5 �1i0 - — <br /> FlR[ALARMRF.OD qFR50N A�DIiION�LPUNCHfCK <br /> �� OINEP "—— <br /> fIRFGPBi��pq��FpO nrn�ov I <br /> V �TR1E BUIIOMC SURCNAqGE <br /> �. I <br /> imeorr,or+st rinr�snrrYn,oveoar CITYOFEVERETT runur,rmnKa � <br /> � V'�1 LOCAL SALES �— <br /> nnr[ "J `J TAX CODE IS 3105 TOTAL C�1 � ���,"�� <br /> �i - <br />